Infectious Mononucleosis Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 16, 2020

What is Infectious Mononucleosis?

Infectious mononucleosis, or mono, is an illness caused by the Epstein Barr Virus that invades the body’s lymph nodes. It is spread by infected saliva. Most children who contract mono do not develop symptoms. While small children can become sick, symptomatic disease usually affects adolescents. 

Symptoms include:

  • Fever
  • Throat pain and pus on the tonsils
  • Swollen lymph nodes especially in the neck
  • Fatigue and sleeping more
  • Generalized rash (less common)

Infectious Mononucleosis Diagnosis and Treatment

Mono can be diagnosed with a blood test called a monspot. In children less than 4 years old, a different blood test is needed to make the diagnosis.

There is no specific treatment for mono. Supportive care targets symptoms. Tylenol and ibuprofen can be used for fever and throat pain. Warm salt water gargles and cold foods can also help soothe a sore throat. In rare cases, when throat swelling blocks the airway sufficiently, steroids might be administered but this is not routine. Rest and hydration are also important.

While mono is not very contagious, its spread can be avoided by:

  • Avoiding kissing until 3-4 days after fever is gone
  • Avoid using the same glasses and utensils
  • Wash hands well and often

Note:

  • Children diagnosed with mono should not participate in contact sports for at least 3-6 weeks after diagnosis. The spleen gets bigger during a mono infection and, if struck, can burst. This can be life threatening
  • In younger children, throat pain and swelling can be severe enough to make it hard to breath and swallow. If your child has difficulty breathing or cannot drink to stay hydrated, take them to the emergency room

Check in with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person if…

  • Fever lasts for great than 7 days
  • Your child develops severe abdominal pain
  • Throat pain becomes severe
  • Throat swelling makes it hard for your child to breath
  • Your child is unable to drink adequately
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.